Published: 16/01/2003, Volume II3, No. 5838 Page 5

Health secretary Alan Milburn has ordered senior officials to carry out an 'exceptional tracking exercise' amid fears that over£320m allocated to cancer care has been diverted elsewhere.

Strategic health authority chief executives have been told to provide figures by the end of the month following concerns that routine service and financial framework returns have contained 'too many omissions and inaccuracies to be useful' in tracking where the cash has gone.

News that this year's cancer cash was going astray was revealed by HSJ last August. Cancer 'czar' Professor Mike Richards had already acknowledged that some funding allocated the year before had been diverted.

NHS director of operations Alan Doran said: 'Continuing speculation about spending levels risks undermining stakeholder and public confidence in the progress that is being made.'

He said that Professor Richards and ministers had 'acknowledged when challenged that in some cases hypothecated funds (£255m hypothecated nationally in 200102) and earmarked funds (£76m earmarked at health authority level in 2002-03) will not have been used entirely on cancer services'.

Now SHAs are being asked to compile data on their spending on drugs recommended by the National Institute for Clinical Excellence, consultants, and service reconfiguration and development.Mr Doran said the data will be used to 'build a shared understanding with local stakeholders about investments to date'.

Professor David Kerr, chair of the Cancer Services Collaborative and professor of clinical oncology at Radcliffe Infirmary, Oxford, welcomed the exercise: 'We have had a strong debate about ringfencing with the health secretary and he was sympathetic. I think we really do need some form of ringfencing. People like us [in cancer networks] are very keen on it, especially as SHAs and primary care trusts are fairly embryonic organisations and the cancer collaboratives really know what to do with the money.'

Professor Kerr said that in many cases, cancer cash was used to balance the books. 'The money was treated like a running tap and used by many HAs to move out of the red and into the black.We also heard it was used on the NHS pay uplift, but I think it will be a very useful exercise to see exactly where it went.'

North London cancer network lead clinician Professor Anthony Goldstone predicted that problems would re-occur unless cancer networks received the cash directly as happens in Scotland. 'It is likely to happen again and to a greater extent.The lack of 'earmarking' in the next financial year of cancer monies gives PCTs even more licence to do as they like.'

Professor Goldstone said that cancer monies had been 'hijacked', but this was a 'reflection of the government's own muddled thinking and inability to give cancer networks any money or any authority'.

And he predicted that tracing the spending would be 'impossible' due to the fact that most problems occurred in the transition year to PCTs.

'Those responsible will be long gone and in new jobs.'

In November, charity CancerBACUP produced an audit of cancer funding showing that 50 per cent of cancer networks had not received their expected allocation of funds in 2002-03. More than 80 per cent did not expect to receive their promised allocated funds in 2003-04.

Chief executive Joanne Rule said: 'We are delighted that the DoH has recognised what we have known for some time and urge early publication of the results.'